It takes supreme effort to maneuver an endoscope while you ligate internal tissue in a created or natural cavity in animals or in the human body, for example varicose veins in the gullet or a duodenal diverticulum, by means of individual elastic bands while observing the ligations through an endoscope if the surgeon is supposed to maneuver the endoscope and activate the release of a number of elastic bands all by himself. Therefore it is common practice for an assistant to help the surgeon while he maneuvers the endoscope and releases elastic bands during the actual ligation.
Furthermore, it is very inconvenient for the patient when the endoscope is lead into the gullet or other openings of the human body. Therefore it most advantageous to perform a safe and quick operation.
For known ligating instruments related to the present invention, the trigger unit is not firmly fixed at the distal end the endoscope, see for example U.S. Pat. No. 6,149,659. Therefore you must hold the trigger unit firmly with one hand, and with the other hand you can draw the trigger cord to obtain the ligation of the desired varix or diverticulum. A third and eventually a fourth hand are needed to hold and maneuver the endoscope.
For known ligating instruments related to the present invention, two or more trigger cords are used in releasing the rubber bands, see, for example U.S. Pat. No. 6,235,040 and WO 9716120. The consequence of having two or more trigger cords is that the cords can cross one another and squeeze, for example a varix, which easily can result in bleeding and put the patient's health at risk and make the treatment very troublesome.